Bone fusion device

ABSTRACT

A bone fusion device provides stability to bones during a bone fusion period. The bones include, for example, the vertebrae of a spinal column. The bone fusion device comprises one or more extendable tabs attached to the bone fusion device by associated rotating means. The bone fusion device is preferably inserted by using an arthroscopic surgical procedure. During arthroscopic insertion of the device, the tabs are pre-configured for compactness. In this compact configuration, the tabs are preferably deposed along and/or within an exterior surface of the bone fusion device. After the bone fusion device has been positioned between the bones, one or more tab(s) are extended. In the preferred embodiment, the position of each tab is related to a positioning element and extending blocks. Typically, the tabs advantageously position and brace the bone fusion device in the confined space between the bones until the bones have fused.

RELATED APPLICATIONS

This application is a continuation-in-part of co-pending U.S. patentapplication Ser. No. 11/484,379, filed on Jul. 10, 2006 and entitled“BONE FUSION DEVICE,” which is a continuation-in-part of U.S. Pat. No.7,727,280, issued on Jun. 1, 2010 and entitled “BONE FUSION DEVICE,”which is a continuation-in-part of abandoned U.S. patent applicationSer. No. 11/264,958, filed on Nov. 1, 2005 and entitled “BONE FUSIONDEVICE,” and which claims priority under 35 U.S.C. § 119(e) of theexpired U.S. Provisional Patent Application Ser. No. 60/624,836, filedNov. 3, 2004, and entitled “BONE FUSION DEVICE,” all of which are herebyincorporated by reference. Additionally, this application claimspriority under 35 U.S.C. § 119(e) of U.S. Provisional Patent ApplicationSer. No. 61/624,155, filed Apr. 13, 2012, and entitled “BONE FUSIONDEVICE,” which is hereby incorporated by reference.

FIELD OF THE INVENTION

This invention relates generally to bone fusion devices. Morespecifically, the present invention relates to devices for fusingvertebrae of the spine that can be inserted arthroscopically.

BACKGROUND OF THE INVENTION

The spinal column is made up of vertebrae stacked on top of one another.Between the vertebrae are discs which are gel-like cushions that act asshock-absorbers and keep the spine flexible. Injury, disease, orexcessive pressure on the discs can cause degenerative disc disease orother disorders where the disc becomes thinner and allows the vertebraeto move closer together or become misaligned. As a result, nerves maybecome pinched, causing pain that radiates into other parts of the body,or instability of the vertebrae may ensue.

One method for correcting disc-related disorders is to insert a fusioncage between the vertebrae to act as a structural replacement for thedeteriorated disc. The fusion cage is typically a hollow metal deviceusually made of titanium. Once inserted, the fusion cage maintains theproper separation between the vertebrae to prevent nerves from beingpinched and provides structural stability to the spine. Also, the insideof the cage is filled with bone graft material which eventually fusespermanently with the adjacent vertebrae into a single unit.

The use of fusion cages for fusion and stabilization of vertebrae in thespine is known in the prior art. U.S. Pat. No. 4,961,740 to Ray, et al.entitled, “V-Thread Fusion Cage and Method of Fusing a Bone Joint,”discloses a fusion cage with a threaded outer surface, where the crownof the thread is sharp and cuts into the bone. Perforations are providedin valleys between adjacent turns of the thread. The cage can be screwedinto a threaded bore provided in the bone structure at the surgical siteand then packed with bone chips which promote fusion.

U.S. Pat. No. 5,015,247 to Michelson entitled, “Threaded SpinalImplant,” discloses a fusion implant comprising a cylindrical memberhaving a series of threads on the exterior of the cylindrical member forengaging the vertebrae to maintain the implant in place and a pluralityof openings in the cylindrical surface.

U.S. Pat. No. 6,342,074 to Simpson entitled, “Anterior Lumbar UnderbodyFusion Implant and Method For Fusing Adjacent Vertebrae,” discloses aone-piece spinal fusion implant comprising a hollow body having anaccess passage for insertion of bone graft material into theintervertebral space after the implant has been affixed to adjacentvertebrae. The implant provides a pair of screw-receiving passages thatare oppositely inclined relative to a central plane. In one embodiment,the screw-receiving passages enable the head of an orthopaedic screw tobe retained entirely within the access passage.

U.S. Pat. No. 5,885,287 to Bagby entitled, “Self-tapping Interbody BoneImplant,” discloses a bone joining implant with a rigid, implantablebase body having an outer surface with at least one bone bed engagingportion configured for engaging between a pair of bone bodies to bejoined, wherein at least one spline is provided by the bone bed engagingportion, the spline being constructed and arranged to extend outwardlyof the body and having an undercut portion.

U.S. Pat. No. 6,582,467 to Teitelbaum et al. entitled, “ExpandableFusion Cage,” discloses an expandable fusion cage where the surfaces ofthe cage have multiple portions cut out of the metal to form sharpbarbs. As the cage is expanded, the sharp barbs protrude into thesubcortical bone of the vertebrae to secure the cage in place. The cageis filled with bone or bone matrix material.

U.S. Pat. No. 5,800,550 to Sertich entitled, “Interbody Fusion Cage,”discloses a prosthetic device which includes an inert generallyrectangularly shaped support body adapted to be seated on hard endplates of vertebrae. The support body has top and bottom faces. A firstpeg is movably mounted in a first aperture located in the support body,and the first aperture terminates at one of the top and bottom faces ofthe support body. Further, the first peg projects away from the one ofthe top and bottom faces and into an adjacent vertebra to secure thesupport body in place relative to the vertebra.

U.S. Pat. No. 6,436,140 to Liu et al. entitled, “Expandable InterbodyFusion Cage and Method for Insertion,” discloses an expandable hollowinterbody fusion device, wherein the body is divided into a number ofbranches connected to one another at a fixed end and separated at anexpandable end. The expandable cage may be inserted in its substantiallycylindrical form and may be expanded by movement of an expansion memberto establish lordosis of the spine. An expansion member interacts withthe interior surfaces of the device to maintain the cage in the expandedcondition and provide a large internal chamber for receiving bonein-growth material. These patents all disclose fusion cage devices thatcan be inserted between vertebrae of the spine in an invasive surgicalprocedure. Such an invasive surgical procedure requires a long recoveryperiod.

SUMMARY OF THE INVENTION

The present invention is a bone fusion device for insertion betweenbones that are to be fused together, such as, for example, the vertebraeof a spinal column. The bone fusion device comprises one or moreextendable tabs. The bone fusion device is in its most compact statewhen the tabs are aligned with the body of the device such that the tabslie within the exterior of the device. In this compact form, the bonefusion device is preferably inserted between the vertebrae by using anarthroscopic procedure. The bone fusion device of some embodiments isfilled with bone graft material. In these embodiments, the bone graftmaterial is typically relocated from the interior to the exterior of thebone fusion device by using a lead screw. After the device has beenpositioned between the vertebrae, and the lead screw is inserted tooptionally deliver the bone graft material, selected tabs are extended.Preferably, two tabs are extended upon rotating a rotating means whereinextending blocks travel up the screw pushing out the angled tabs as theextending blocks approach the ends of the bone fusion device. Theposition of each tab relative to the bone fusion device is adjustabledepending upon the configuration of the associated rotating means. Inthis way, the tabs are advantageously positioned in the confined spacebetween the vertebrae to help brace the device until the bone has fused.Further, the tabs of the bone fusion device provide a larger surfacearea to which the bones attach and fuse during a healing period.

In some embodiments, the body of the bone fusion device is a roundcylinder with end faces. The bone fusion device has conduits or holesthat allow the bone graft material within the device to flow to theexterior of the device where the material contacts and grafts to thevertebrae. The extendable tabs are arranged in various configurations onthe exterior of the bone fusion device, including the end faces.Preferably, the bone fusion device is rectangular and the tabs areattached to the body of the device on more than one side to optimallybrace the device from multiple directions between the adjacentvertebrae. Alternatively, the bone fusion device has a rectangular shapewith end faces and extendable tabs attached to multiple exteriorsurfaces. In some embodiments, the bone fusion device of someembodiments includes protrusions, threading, and/or sharp features onthe exterior surface and/or the extendable tabs. These features areconfigured to engage the adjacent vertebrae to provide a tighterinterface between the device and the vertebrae. In some embodiments, thetabs comprise stops to prevent the tabs from extending too far out ofthe body. In some embodiments, the device comprises a radio frequencyidentifier chip for providing information about the device and/or otherinformation. In some embodiments, the device comprises one or moreretention springs for biasing the tabs in the retracted position. Insome embodiments, the tabs comprise a plurality of nested levels thatenable the extending of the tabs to comprise the telescoping of thelevels in order to increase stability and the amount of extension. Insome embodiments, the tabs comprise one or more tongues that increasethe top surface area of the tabs such that there is more surface area tocontact and fuse to the bones.

One aspect of the application is directed to a bone fusion device forinsertion into a desired location. The bone fusion device comprises abody having a first end and an interior cavity, one or more tabsconfigured to selectively move from a retracted position within the bodyto an extended position extending out of the body in order to brace thebone fusion device in the desired location, a positioning elementpositioned through the first end of the body and substantially withinthe interior cavity of the body, one or more extending blocks coupled tothe positioning element for moving the one or more tabs between theretracted position and the extended position and one or more retentionsprings configured to apply a force to the tabs biasing the tabs in theretracted position. In some embodiments, the retention springs compriseone or more wires coupled to the body and positioned such that the wiresimpede a portion of the tabs from moving to the extended positionthereby biasing the tabs in the retracted position. In some embodiments,the portion of each of the tabs comprise one or more channels thatreceive a portion of the wires in order to prevent the wires fromslipping off of the portion of the tabs. In some embodiments, theportion of each of the tabs comprise one or more apertures through whichthe wires are threaded in order to secure wires to the portion of thetabs. In some embodiments, the retention springs comprise one or morewires each surrounding the tabs such that the wires resist separation ofthe tabs thereby biasing the tabs in the retracted position. In someembodiments, the retention springs comprise one or more wires coupled tothe body and the tabs such that the wires resist movement of the tabswith respect to the body thereby biasing the tabs in the retractedposition. In some embodiments, the retention springs comprise one ormore wires each coupled to two or more of the tabs such that the wiresresist separation of the two or more tabs thereby biasing the tabs inthe retracted position. In some embodiments, the retention springscomprise one or more flexible portions of the body positioned such thatthe flexible portions of the body impede a portion of the tabs frommoving to the extended position thereby biasing the tabs in theretracted position.

A second aspect of the application is directed to a bone fusion devicefor insertion into a desired location. The bone fusion device comprisesa body having a first end, an interior cavity and an inner surfacehaving one or more recesses, one or more tabs each having one or morestops protruding from the perimeter of the tabs, wherein the tabs areconfigured to selectively move from a retracted position within the bodyto an extended position extending out of the body in order to brace thebone fusion device in the desired location, a positioning elementpositioned through the first end of the body and substantially withinthe interior cavity of the body and one or more extending blocks coupledto the positioning element for moving the one or more tabs between theretracted position and the extended position, wherein the recesses areconfigured to receive the stops when the tabs are inserted into the bodyand to prevent the tabs from separating from the body by blocking theoutward movement of the stops when the tabs are in the extendedposition. In some embodiments, the bottom of the outward surface of eachof the stops is closer to the perimeter of the tabs than the top of theoutward surface of each of the stops such that each the stop comprisesan angled outward face with respect to the perimeter of the tabs inorder to facilitate the insertion of the stops into the recesses of thebody. In some embodiments, a top portion of each of the stops isseparated from the perimeter of the tabs such that the top portion isable to flex toward the perimeter of the tabs in order to facilitate theinsertion of the stops into the recesses of the body. In someembodiments, the device further comprises one or more retention springsconfigured to apply a force to the stops of the tabs thereby biasing thetabs in the retracted position. In some embodiments, the retentionsprings comprise one or more wires coupled to the body and positionedsuch that the wires impede the stops of the tabs from moving to theextended position thereby biasing the tabs in the retracted position. Insome embodiments, the retention springs comprise one or more wirescoupled to the body and the stops of the tabs such that the wires resistmovement of the tabs with respect to the body thereby biasing the tabsin the retracted position. In some embodiments, the retention springscomprise one or more wires each coupled to the stops of two or more ofthe tabs such that the wires resist separation of the two or more tabsthereby biasing the tabs in the retracted position. In some embodiments,the retention springs comprise one or more flexible portions of the bodypositioned such that the flexible portions of the body impede the stopsof the tabs from moving within the recesses when the tabs are movingtoward the extended position thereby biasing the tabs in the retractedposition.

Yet another aspect of the application is directed to a telescoping bonefusion device for insertion into a desired location. The telescopingbone fusion device comprises a body having a first end and an interiorcavity, one or more tabs each having a plurality of nested levelsconfigured to selectively telescope between a retracted position withinthe body and extended positions extending out of the body in order tobrace the bone fusion device in the desired location, a positioningelement positioned through the first end of the body and substantiallywithin the interior cavity of the body and one or more extending blockscoupled to the positioning element for moving the nested levels of theone or more tabs between the retracted position and the extendedpositions. In some embodiments, each of the nested levels of each tabhas a maximum extended position that is different than the maximumextended position of the other nested levels of the tab. In someembodiments, the distance from the body of the maximum extended positionfor each of the nested levels of each tab increases from the outermostnested level to the innermost nested level. In some embodiments, each ofthe nested levels of each tab include an inner surface having a profilethat is different than the inner surface profile of the other nestedlevels of the tab, and further wherein at least one of the extendingblocks is configured to contact the inner surfaces when moving thenested levels between the retracted position and the extended positions.In some embodiments, the one or more extending blocks comprise aplurality of upper surfaces at different heights, and further whereinthe upper surfaces at each height are associated with one or more of thenested levels such that the upper surfaces of that height contact theassociated nested levels when moving the nested levels between theretracted position and the extended positions. In some embodiments, theinnermost nested level of each tab comprises one or more tongues thatextend from the top surface of the innermost nested level to theperimeter of the tab. In some embodiments, the non-innermost nestedlevels of each tab comprise one or more recesses that align with the oneor more tongues such that when the innermost nested level is nestedwithin one or more of the non-innermost nested levels the tongues slidewithin the recesses.

Another aspect of the application is directed to a method of implantinga telescoping bone fusion device. The method comprises inserting thebone fusion device into a desired location, wherein the bone fusiondevice comprises a body, a positioning element, one or more extendingblocks and one or more moveable tabs each having a plurality of nestedlevels configured to selectively telescope between a retracted positionwithin the body and extended positions extending out of the body inorder to brace the bone fusion device in the desired location,pre-configuring the one or more moveable tabs to the retracted positionwith the positioning element and the plurality of extending blocks suchthat the bone fusion device has a minimized form factor and telescopingeach of the nested levels of the one or more tabs to desired extendedpositions by moving the plurality of extending blocks with thepositioning element. In some embodiments, rotating the positioningelement moves the plurality of extending blocks. In some embodiments,each of the nested levels of each tab has a maximum extended positionthat is different than the maximum extended position of the other nestedlevels of the tab. In some embodiments, the distance from the body ofthe maximum extended position for each of the nested levels of each tabincreases from the outermost nested level to the innermost nested level.In some embodiments, each of the nested levels of each tab include aninner surface having a profile that is different than the inner surfaceprofile of the other nested levels of the tab, and further wherein thetelescoping comprises at least one of the extending blocks contactingthe inner surfaces of each of the nested levels when being moved by thepositioning element. In some embodiments, the one or more extendingblocks comprise a plurality of upper surfaces at different heights andthe upper surfaces at each height are associated with one or more of thenested levels, and further wherein the telescoping comprises the uppersurfaces of the extending blocks at a height contacting the associatednested levels when being moved by the positioning element. In someembodiments, the innermost nested level of each tab comprises one ormore tongues that extend from the top surface of the innermost nestedlevel to the perimeter of the tab. In some embodiments, thenon-innermost nested levels of each tab comprise one or more recessesthat align with the one or more tongues such that when the innermostnested level is nested within one or more of the non-innermost nestedlevels the tongues slide within the recesses. In some embodiments, themethod further comprises inserting a distraction instrument having anindicator and a pair of distraction plates into the desired location,separating the distraction plates and displaying informationcorresponding to the separation of the distraction plates with theindicator.

Another aspect of the application is directed to a bone fusion devicefor insertion into a desired location. The bone fusion device comprisesa housing comprising first and second ends, one or more tabs for bracingthe bone fusion device in a space in the desired location, each tabcomprising a first tab end proximate the first end and a second tab enddistal from the first end and proximate the second end, a positioningelement positioned through the first end and a plurality of extendingblocks coupled to the positioning element and in contact with the one ormore tabs for moving the one or more tabs, wherein as the positioningelement moves in a first direction the plurality of extending blocksraise the tabs toward an extended position and directly support thefirst tab end or the second tab end when in the extended position. Insome embodiments, the device further comprises a radio frequencyidentification device that uniquely identifies the bone fusion device.

Another aspect of the application is directed to a method of implantinga bone fusion device in a desired location. The method comprisesinserting the bone fusion device in the desired location, wherein thebone fusion device comprises a first end, a second end, an internalcavity, a positioning element, a plurality of extending blocks and oneor more moveable tabs each in contact with one of the extending blocksand comprising a first tab end proximate the first end and a second tabend distal from the first end and proximate the second end and extendingthe one or more tabs to an extended position by moving at least one ofthe plurality of extending blocks toward the first end or the second endof one or more of the tabs by rotating the positioning element, whereinthe at least one extending block directly supports the first tab end orthe second tab end of the one or more of the tabs when the tabs are inthe extended position. In some embodiments, the method further comprisesinserting a distraction instrument having an indicator and a pair ofdistraction plates into the desired location, separating the distractionplates and displaying information corresponding to the separation of thedistraction plates with the indicator.

Yet another aspect of the application is directed to a method ofoperating the retraction instrument for implanting a bone fusion devicehaving one or more tabs and a positioning element. The method comprisesinserting a distraction instrument having an indicator and a pair ofdistraction plates into a desired location, separating the distractionplates and displaying information corresponding to the separation of thedistraction plates with the indicator. In some embodiments, thedisplayed information indicates the amount of separation between thedistraction plates. In some embodiments, the displayed informationindicates the amount of force resisting the distraction of the plates.In some embodiments, the displayed information indicates a size or typeof bone fusion device. In some embodiments, the displayed informationindicates a number of rotations that the positioning element of the bonefusion device will require in order to extend the one or more tabs suchthat the height of the bone fusion device equal the amount ofdistraction of the distraction plates. In some embodiments, the desiredposition comprises between one or more vertebrae. In some embodiments,the method further comprises collapsing the distraction plates togetherand removing the distraction instrument from the desired location.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a bone fusion device in accordance with someembodiments of the invention.

FIG. 2 illustrates a bone fusion device according to an alternativeembodiment of the present invention.

FIGS. 3A-B illustrate a section of a vertebral column showing the bonefusion device inserted between two adjacent vertebrae in place of anintervertebral disc.

FIGS. 4A-B illustrate a detailed view of the worm screw drive and theextendable tabs of some embodiments.

FIGS. 5A-B illustrate the small form factor of some embodiments.

FIGS. 6A-B illustrate a cross section view of the small form factor ofsome embodiments.

FIGS. 7A-B are perspective drawings illustrating the tabs and tab baysof some embodiments.

FIG. 8 illustrates a process flow in accordance with some embodiments ofthe invention.

FIG. 9 illustrates a top perspective view of the bone fusion device insome embodiments of the invention.

FIG. 10 illustrates a top/side perspective view of the bone fusiondevice in some embodiments of the invention.

FIG. 11 illustrates a top/side perspective view of the bone fusiondevice in some embodiments of the invention.

FIG. 12 illustrates a section of a vertebral column showing the bonefusion device inserted between two adjacent vertebrae in place of anintervertebral disc.

FIG. 13 illustrates a side perspective view of the bone fusion device inanother embodiment of the present invention.

FIG. 14A illustrates a cross sectional view of the bone fusion devicewith the tabs compacted in another embodiment of the invention.

FIG. 14B illustrates a cross sectional view of the bone fusion devicewith the tabs extended in another embodiment of the invention.

FIG. 15 illustrates a top perspective view of the bone fusion device inthe preferred embodiment of the invention.

FIG. 16 illustrates a side perspective view of the bone fusion device inthe preferred embodiment of the present invention.

FIG. 17 illustrates a cross-sectional view of components of the bonefusion device in the preferred embodiment of the present invention.

FIG. 18A illustrates a cross sectional view of the bone fusion devicewith the tabs compacted in the preferred embodiment of the invention.

FIG. 18B illustrates a cross sectional view of the bone fusion devicewith the tabs extended in the preferred embodiment of the invention.

FIG. 19 illustrates a perspective view of a bone fusion device havingone or more stops according to some embodiments.

FIG. 20 illustrates a frontal view of a tab having one or more stopsaccording to some embodiments.

FIG. 21A illustrates a side cross-sectional view of a contracted bonefusion device having one or more retention springs according to someembodiments.

FIG. 21B illustrates a side cross-sectional view of an extended bonefusion device having one or more retention springs according to someembodiments.

FIG. 21C illustrates a side cross-sectional view of an extended bonefusion device having one or more retention springs according to someembodiments.

FIG. 21D illustrates a front cross-sectional view of a tab of a bonefusion device having one or more retention springs according to someembodiments.

FIG. 21E illustrates a side cross-sectional view of an extended bonefusion device having one or more retention springs according to someembodiments.

FIG. 21F illustrates a side cross-sectional view of an extended bonefusion device having one or more retention springs according to someembodiments.

FIG. 21G illustrates a side cross-sectional view of an extended bonefusion device having one or more retention springs according to someembodiments.

FIG. 21H illustrates a perspective view of a bone fusion device havingone or more retention springs according to some embodiments.

FIG. 21I illustrates a cross-sectional view of a retracted bone fusiondevice having one or more retention springs according to someembodiments.

FIG. 21J illustrates a cross-sectional view of an extended bone fusiondevice having one or more retention springs according to someembodiments.

FIG. 22A illustrates a side cross-sectional view of a bone fusion devicehaving one or more tabs with telescoping levels according to someembodiments.

FIG. 22B illustrates a top view of a bone fusion device having one ormore tabs with telescoping levels according to some embodiments.

FIG. 22C illustrates an exploded side cross-sectional view of a bonefusion device having one or more tabs with telescoping levels accordingto some embodiments.

FIG. 22D illustrates a bottom cross-sectional view of a bone fusiondevice having one or more tabs with telescoping levels according to someembodiments.

FIG. 22E illustrates a side cross-sectional view of a bone fusion devicehaving one or more tabs with telescoping levels with tongues accordingto some embodiments.

FIG. 22F illustrates a top view of a bone fusion device having one ormore tabs with telescoping levels with tongues according to someembodiments.

FIG. 22G illustrates a perspective view of a extending block of a bonefusion device having one or more tabs with telescoping levels accordingto some embodiments.

FIG. 23 illustrates a flow chart of a method of implanting a telescopingbone fusion device between bones according to some embodiments.

FIG. 24 illustrates a perspective view of a distraction instrument formeasuring the space to be filled by a bone fusion device according tosome embodiments.

FIG. 25 illustrates a top cross sectional view of the distraction bodyaccording to some embodiments.

FIG. 26 illustrates a perspective view of the components of theretraction head of the retraction instrument according to someembodiments.

FIG. 27A illustrates cross sectional view of the head of the retractioninstrument with the plates fully retracted according to someembodiments.

FIG. 27B illustrates cross sectional view of the head of the retractioninstrument with the plates fully extended according to some embodiments.

FIG. 28 illustrates a flow chart of a method of operating the retractioninstrument according to some embodiments.

DETAILED DESCRIPTION

In the following description, numerous details and alternatives are setforth for purpose of explanation. However, one of ordinary skill in theart will realize that the invention can be practiced without the use ofthese specific details. For instance, the figures and description belowoften refer to the vertebral bones of a spinal column. However, one ofordinary skill in the art will recognize that some embodiments of theinvention are practiced for the fusion of other bones, including brokenbones and/or joints. In other instances, well-known structures anddevices are shown in block diagram form in order not to obscure thedescription of the invention with unnecessary detail.

FIG. 1 illustrates a bone fusion device 100 in accordance with someembodiments of the invention. As shown in this figure, the bone fusiondevice 100 has a round cylindrical shape and has two end faces,including the end face 140. In some embodiments, the bone fusion device100 is constructed from a high strength biocompatible material, such astitanium, which has the strength to withstand compressive and shearforces in the spine that are generated by a patient's body weight anddaily movements. The base biocompatible material is often textured orcoated with a porous material conducive to the growth of new bone cellson the bone fusion device 100. Also shown in FIG. 1 , the end face 140has an opening 145 which allows the insertion of bone graft materialinto the bone fusion device 100. The bone graft material includes bonechips from the same patient (autograft), bone chips from a donor(allograft or xenograft), and/or a synthetic bone matrix. The bone graftmaterial typically promotes bone growth during a recovery period afterthe patient receives bone fusion surgery. As further illustrated in FIG.1 , the bone fusion device 100 has several conduits or holes 150, whichpermit the bone graft material to contact the vertebral bone after thedevice 100 has been inserted between the vertebrae of the patient. Thebone graft material and the surface texturing of the device 100encourage the growth and fusion of bone from the neighboring vertebrae.The fusion and healing process will result in the bone fusion device 100becoming embedded within the two adjacent vertebrae of the spine whicheventually fuse together during the healing period.

As further illustrated in FIG. 1 , several tabs 131, 132, 133, 134, 135,and 136 are distributed along the round cylindrical body of the bonefusion device 100. These tabs 131-136 are each attached to the bonefusion device 100 by a respective rotating means 111, 112, 113, 114,115, and 116. The rotating means 111-116 is typically a turn screw typeassembly. When the bone fusion device 100 is inserted into the patient'sbody, the tabs 131-136 lie along the body of the device 100, as shown bythe dotted outlines 121-126 of the tabs. Thus, the unextended tabs121-126 of the bone fusion device 100 provide a compact assembly that issuitable for insertion into the patient's body through an arthroscopicsurgical procedure. An arthroscopic procedure is considered minimallyinvasive and has certain advantages over more invasive conventionalsurgical procedures. In an arthroscopic procedure, a smaller surgicalincision is employed as compared to the size of the incision requiredfor conventional invasive surgery. Moreover, arthroscopic proceduresminimize or eliminate the need for excessive retraction of a patient'stissues such as muscles and nerves, thereby minimizing trauma and injuryto the muscles and nerves and further reducing the patient's recoverytime.

After insertion of the device 100 into the space between the patient'svertebrae, the surgeon selectively extends particular tabs 131-136 byrotating each selected tab's respective rotating means 111-116. The moreeach rotating means 111-116 is rotated, the farther its respective tab131-136 elevates and extends outward from its initial position 121-126along the body of the device 100. Each tab's 131-136 position isindividually adjustable so as to optimally brace the device 100 betweenthe vertebrae. Due to the compressive forces commonly associated withspinal column vertebrae, some embodiments include a range of motion foreach tab that is slightly greater than 90 degrees. It was particularlydiscovered during the reduction to practice of this aspect of thepresent invention, that the tabs of these embodiments are rotated to anangle that is slightly more than about 90 degrees with respect to thesurface of the bone fusion device. The tabs extended in thisconfiguration were found to be capable of withstanding the greatestamount of compressive force.

The tabs 131-136, when extended, abut tightly against the surfaces ofthe vertebrae that are immediately adjacent to the bone fusion device100. In some embodiments, the tabs 131-136 have sharp protrusions alongthe length of the tab for engaging the adjacent vertebrae, while thetabs 131-136 of some embodiments have screw-type threads for screwinginto and engaging the vertebrae. Optionally, the tabs of someembodiments have surface texturing to encourage and enhance the growthof new bone on the tabs 131-136. This surface texturing is often similarto the surface texturing used on the main body of the device 100.Regardless of their texturing and/or particular physicalcharacteristics, the tabs 131-136 advantageously wedge the bone fusiondevice 100 in a fixed position between the vertebrae and provide alarger surface area with which the adjacent vertebrae fuses during thehealing period. Moreover, bone growth material, such as protein, istypically applied to the tabs 131-136 to stimulate the regeneration ofbone cells needed for bone fusion. The application of bone growthmaterial is described further in relation to FIG. 4 .

In an alternative embodiment of the invention, the tabs of the device100 have sharp ridges or threads which bite into the adjacent vertebrae,further helping to brace the device between the vertebrae. It will bereadily apparent to one skilled in the art that there are a number ofvariations for the body and the tabs 131-136 of the bone fusion device100. For instance, the bone fusion device 100 employs different numbersand/or configurations of tabs in different embodiments. Hence, the tabs131-136 depicted in FIG. 1 are merely exemplary. Moreover, the tabs131-136 are located anywhere over the exterior surface of the bonefusion device 100, in a variety of orientations. Specifically, the tabs131-136 are arranged such that when they are extended, the tabs 131-136act to stabilize the bone fusion device 100 against the vertebrae fromseveral points and directions. Typically, the tighter the bone fusiondevice 100 is wedged between the adjacent vertebrae by the tabs 131-136,the more stability the device 100 provides to the vertebrae and thespine of the patient. The tabs 131-136 of the embodiments describedabove are critical to insure that the device 100 is not dislodged, sincemovement of the device 100 could cause serious injury to the patient,and especially because the inserted device is situated near thepatient's spinal cord.

FIG. 2 shows an alternative embodiment of the bone fusion device 200. Asshown in this figure, the bone fusion device 200 of some embodiments hasa rectangular shape. Similar to the round cylindrical shaped bone fusiondevice 100 shown in FIG. 1 , the rectangular bone fusion device 200 hastwo end faces, including the end face 245 visible in FIG. 2 , andmultiple tabs 211, 212, 213, 214, 215, 216, 217, and 218 that areattached by rotating means to the exterior surface. The rotating meansare screw type assemblies in some embodiments. The tabs 211-218 are alsoselectively extended after insertion of the bone fusion device 200between the vertebrae. As before, the insertion of the bone fusiondevice 200 and the extension of the selected tabs 211-218, are typicallyperformed by a surgeon during an arthroscopic surgical procedure. Theprocedure of some embodiments is further described in relation to FIG. 8. The rotation of a respective rotating means associated with each tab211-218, individually adjusts the position of the associated tab 211-218such that the device 200 is firmly braced between the two adjacentvertebrae. One skilled in the art will recognize that the tabs 211-218are distributed over the exterior surfaces of the bone fusion device 200in a variety of configurations, which include the ends and the surfacesof the device 200 that are not readily visible in FIG. 2 . Moreover, asmentioned above, different numbers of tabs 211-218 are distributed overeach surface of the bone fusion device 200 of different embodiments. Insome embodiments, the surfaces of the bone fusion device 200 and/or thetabs 211-218, are coated with a porous surface texturing which promotesbone growth.

The end face 245 has an opening 240, which provides access to a cavitywithin the interior of the bone fusion device 200. In some embodiments,bone graft materials, such as the bone chips and/or the synthetic bonematrix that were mentioned above, are pre-loaded into the cavity withinthe bone fusion device 200 through the opening 240. Several conduits orholes 250 in the bone fusion device 200 permit the bone graft materialto flow from the interior cavity to the exterior surfaces of the device200 that are in contact with the vertebral bone. Typically, the bonegraft material is relocated from the interior cavity to the exterior ofthe bone fusion device 200, after the device 200 has been positionedbetween the vertebrae. However, in some embodiments the bone graftmaterial is delivered to the site of the bone fusion device 200 byarthroscopic means that originate external to the device 200. Regardlessof the delivery means, the bone graft material and the surface texturingof the bone fusion device 200 encourage bone growth and fusion with theadjacent vertebrae that are in contact with the device 200. As bonefusion and healing progresses, the bone fusion device 200 becomesembedded within the two fused vertebrae of the spine.

FIG. 3A illustrates a section of a vertebral column that has a bonefusion device 300 positioned between two vertebrae 330 and 335. As shownin this figure, the bone fusion device 300 is positioned in a locationwhere an intervertebral disc would normally reside. A flexible disc istypically sandwiched between the two vertebrae of a normal healthyspinal column. For instance, the normal, healthy disc 340 is sandwichedbetween the vertebrae 337 and 330. However, for the spinal columnillustrated in FIG. 3 , the intervertebral disc that normally residesbetween the vertebrae 330 and 335 has been excised and surgicalinsertion of the bone fusion device 300 has replaced the disc as thesupporting structure between the vertebrae 330 and 335.

FIG. 3A further illustrates that the damaged disc that is normallysandwiched between vertebrae 330 and 335 has been totally removed.However, complete removal of the disc is not necessary in order to usethe bone fusion device 300 of some embodiments. Typically, only as muchof the disc needs to be excised as is required to permit the placementand positioning of the bone fusion device 300. Additionally, asufficient amount of the disc is typically removed that allows access tothe rotating means 311, 312, 313, and 314, which control the extensionof the tabs 321, 322, 323, and 324, of the bone fusion device 300. Asmentioned above, additional numbers and configurations of the tabs aredistributed over the exterior surfaces of the bone fusion device 300,including the surfaces that are not visible in FIG. 3A.

During the insertion and placement of the bone fusion device 300, thetabs 321-324 are deposed in a position aligned along the body of thebone fusion device 300, such that the tabs 321-324 lie substantiallywithin the exterior surfaces of the device 300. In some embodiments, thetabs 321-324 are flush with the exterior surface. In these embodiments,the form factor of the bone fusion device 300 is configured to be ascompact as possible. For instance, the form factor of some embodimentshas a diameter of approximately 0.28 inches and a length ofapproximately 1.0 inch. In contrast, the form factor of these sameembodiments has a diameter of approximately 0.48 inches when the tabs321-324 are fully extended.

By minimizing the space occupied, the bone fusion device 300 isadvantageously inserted arthroscopically into the patient's body. Ifinstead, the device 300 were inserted in its fully extended form, alarger surgical incision would be required, and a greater displacementof the muscles and nerves would be needed. However, its compact formfactor allows the bone fusion device 300 to be inserted byadvantageously utilizing minimally invasive arthroscopic techniques.Then, the tabs 321-324 of the bone fusion device 300 are extended afterarthroscopic insertion to optimally increase the form factor and bracethe device 300 between the vertebrae 330 and 335. In some embodiments,selected tabs 321-324 are extended.

While the particular embodiment described above has a rectangular shape,it will be readily apparent to one skilled in the art that thecross-section of the bone fusion device 300 has different shapes invarious embodiments. For instance, a more circular bone fusion devicesuch as the device 100 illustrated in FIG. 1 , or a device havinganother shape is employed in conjunction with a set of extendable tabsthat are located in various configurations in additional embodiments ofthe invention. For instance, some embodiments have four rows of tabs,where each row is positioned on a side of the bone fusion device. Insome of these embodiments, each row has four tabs. Such an embodiment isfurther described in relation to FIG. 7 and is illustrated in itsinserted form in FIG. 3B. As shown in FIG. 3B, a first set of four tabs311-314 lock the bone fusion device 300 against the vertebra 330, whilea second set of tabs 315-318 lock the bone fusion device 300 against thevertebra 335.

FIG. 4A illustrates the bone fusion device 400 of some embodiments infurther detail. As shown in this figure, the bone fusion device 400includes an interior cavity 405 for the insertion of a lead screw 415,and one or more tabs 431 each deposed in a tab bay 421, 422, 423, 424.

The tab bays 421-424 allow the tabs 431 to lie flush and/or within theexterior surface 420 of the bone fusion device 400 when not extended.Also when not extended, the tab 431 and tab bay 421 provides a conduit450 from the interior cavity 405 to the exterior surface 420 of the bonefusion device 400, such that the bone graft and/or growth materialwithin the interior cavity 405 has a directed path to the exteriorsurface 420. Typically, the insertion of the lead screw 415 forces thematerial within the interior cavity 405 to relocate to the exteriorsurface 420.

The tab 431 includes a rotating means 411 and gear teeth 455. When thetab 431 is not extended, the gear teeth 455 provide a series of passivegrooves by which the lead screw 415 traverses the interior cavity 405.Typically, the tab 431 remains fixed as the lead screw 415 is screwedinto the interior cavity 405. In these embodiments, the threading of thelead screw 415 does not address or affect the gear teeth 455 during theinsertion of the lead screw 415.

However, the gear teeth 455 do employ the threading of the lead screw415 when the lead screw 415 has been fully inserted into the cavity 405,in some embodiments. For instance, in a particular implementation of theinvention, the lead screw 415 is driven into the cavity 405, until itreaches an endcap 406. The endcap 406 allows the lead screw 415 tocontinue rotating in place, but does not allow the lead screw 415 tocontinue its forward progress through the cavity 405. When the leadscrew 415 of these embodiments rotates without making forward progress,the rotating lead screw's threading contacts and engages the gear teeth455 of each tab 431. Accordingly, the motion and angle of the spiralingthreads, when applied against the gear teeth 455, causes the tabs 431 toelevate and extend. The combination of the gear teeth 455 on the tabs431 and the inserted lead screw 415, is referred to, in someembodiments, as a worm screw drive mechanism.

In an alternative embodiment of the worm screw drive mechanism, therotating means 411 is turned to raise the tab 431. In these embodiments,the rotating means 411 for the tab 431 typically comprises a turn screwtype mechanism such that when the rotating means 411 is turned, the gearteeth 455 drive or rotate against the stationary threads of the insertedlead screw 415. Similarly, due to the angle of the stationary leadscrew's spiral threads, the gear teeth 455 cause the tab 431 to elevateand extend above the exterior surface 420 of the bone fusion device 400.

As mentioned above, the tabs 431 of some embodiments have a range ofmotion that exceeds 90 degrees with respect to the exterior surface 420of the bone fusion device 400. Accordingly, FIG. 4B illustrates the tab431 extended slightly past 90 degrees, which is the optimum position towithstand the compressive force exerted on the vertebrae of someembodiments.

FIG. 5A illustrates a closed view of the small form factor for a bonefusion device 500 in accordance with some embodiments. As shown in thisfigure, the bone fusion device 500 has a tab 531 that is not extendedand lies within the exterior surface of the device 500. In contrast,FIG. 5B illustrates the form factor for the bone fusion device 500 withthe tab 531 extended, as described above. Similarly, FIG. 6A illustratesa cross section view of the bone fusion device 600 having a small formfactor, while FIG. 6B illustrates the cross section view with the tab631 extended.

FIG. 7A is a perspective drawing illustrating the bone fusion device 700with four tab bays on four opposite sides of the device 700, accordingto some embodiments of the invention. As described above, a tab isdeposed in each tab bay and secured by a rotating means. For instance,the tab 731 is deposed in the tab bay 721 and secured by the rotatingmeans 711. Also shown in FIG. 7A, a lead screw 715 is driven into thecavity. As described above, the lead screw 715 provides the thread bywhich the gear teeth 755 elevate the tabs 731-733. Accordingly, FIG. 7Billustrates the bone fusion device 700 with the tabs 731-733 elevated.

FIG. 8 is a process flow diagram that summarizes the insertion and useof the bone fusion device according to some embodiments. As shown inthis figure, the process 800 begins at the step 805 where a small,minimally invasive surgical incision is performed. The small incision istypically only large enough to permit entry of an arthroscopic surgicaltool. Then, the process 800 transitions to the step 810, where the bonefusion device is inserted through the small incision and delivered to aregion between two vertebrae that are to be fused together. Insertionand delivery of the bone fusion device are performed by usingarthroscopic tool(s).

At the step 815, the bone fusion device is positioned in the regionwhere bone fusion is to occur, also typically by using one or morearthroscopic tool(s). Once the bone fusion device is positioned in theregion between the two vertebrae, the process 800 transitions to thestep 820, where the lead screw is inserted and driven into the bonefusion device. The lead screw is typically driven into a cavity in thecenter of the bone fusion device. The cavity contains a bone growthmaterial comprising collagen and/or a matrix for the promotion of bonegrowth. Accordingly, insertion of the lead screw into the cavity causesthe bone growth material to be relocated from the interior cavity to theexterior surface of the bone growth device. The bone fusion device ofsome embodiments has a particular pattern of conduits or pores thatextend from the interior cavity to the exterior surface for facilitatingthe relocation of bone growth material to particular locations at theexterior of the device. For instance, some embodiments have pores thatfacilitate the relocation of bone growth material to particular tabs.

At the step 825 of the FIG. 8 , the tabs are selectively extended tolock the bone fusion device in place in the region between the twovertebrae. The tabs of some embodiments are extended by using the wormscrew drive mechanism described above in relation to FIG. 4 . Once theselected tabs are extended and the bone fusion device is secured inplace at the step 825, the surgical tools are removed from the patient,and the small incision is sutured. Then, the process 800 concludes.

FIG. 9 illustrates a top perspective view of the bone fusion device insome embodiments. As shown in this figure, the bone fusion device 1000has a substantially rectangular shape and has two end faces. In someembodiments, the bone fusion device 1000 is constructed from a highstrength biocompatible material, such as titanium, which has thestrength to withstand compressive and shear forces in the spine that aregenerated by a patient's body weight and daily movements. The basebiocompatible material is often textured or coated with a porousmaterial conducive to the growth of new bone cells on the bone fusiondevice 1000. As further illustrated in FIG. 9 , the bone fusion device1000 has several conduits or holes 1014 which permit the bone graftmaterial to contact the vertebral bone after the device 1000 has beeninserted between the vertebrae of the patient. The bone graft materialand the surface texturing of the device 1000 encourage the growth andfusion of bone from the neighboring vertebrae. The fusion and healingprocess will result in the bone fusion device 1000 becoming embeddedwithin the two adjacent vertebrae of the spine which eventually fusetogether during the healing period.

As further illustrated in FIG. 9 , a first tab 1006 is located on afirst side and a second tab 1006 (FIG. 14A) is located on an opposingsecond side. These tabs 1006 are shaped so that their outer surface issubstantially flush with the frame 1004 of the bone fusion device 1000in an unextended position. Internally, the tabs 1006 have an angledinner surface. Each tab 1006 is shaped such that one end issubstantially larger than the opposing smaller end, and the size of thetab in between gradually decreases while going from the larger end tothe opposing smaller end. A positioning means 1002 is coupled to anextending block or nut 1010 which travels up or down the positioningmeans 1002 depending on which way the positioning means 1002 is turned.The positioning means 1002 is typically a screw type assembly. Turningthe positioning means 1002 clockwise causes the extending block 1010 tomove up the positioning means 1002 towards the head of the positioningmeans 1002, whereas turning the positioning means 1002 counterclockwisemoves the extending block 1010 away from the head of the positioningmeans 1002. When the extending block 1010 is positioned away from thehead of the positioning means 1002, the angled tabs 1006 are compact andare within the frame 1004 of the bone fusion device 1000. Thus, theunextended tabs 1006 of the bone fusion device 1000 provide a compactassembly that is suitable for insertion into the patient's body throughan arthroscopic surgical procedure. An arthroscopic procedure isconsidered minimally invasive and has certain advantages over moreinvasive conventional surgical procedures. In an arthroscopic procedure,a smaller surgical incision is employed as compared to the size of theincision required for conventional invasive surgery. Moreover,arthroscopic procedures minimize or eliminate the need for excessiveretraction of a patient's tissues such as muscles and nerves, therebyminimizing trauma and injury to the muscles and nerves and furtherreducing the patient's recovery time. As the positioning means 1002 isrotated causing the extending block 1010 to move closer to the head ofthe positioning means 1002, the extending block 1010 pushes the angledtabs 1006 outward causing the tabs 1006 to assert pressure againstsurrounding bones and securing the bone fusion device 1000 in place.When the extending block 1006 reaches as close to the head of thepositioning means 1002 as allowed, the tabs 1006 are fully extended.Furthermore, since the extending block 1010 travels along thepositioning means 1002, such as along the threads of a screw, veryprecise positions of the tabs 1006 are able to be achieved.

FIG. 10 illustrates a top/side perspective view of the bone fusiondevice 1000 in some embodiments. As described above, the bone fusiondevice 1000 has tabs 1006 initially positioned so that they fit withinthe frame 1004 of the bone fusion device 1000. The positioning means1002 is positioned through the first end face 1018 so that the extendingblock 1010 is able to travel along the positioning means 1002 causingthe tabs 1006 to extend outwardly beyond the frame 1004 of the bonefusion device 1000. The positioning means 1002 is able to be any devicethat allows such functionality. Furthermore, if a screw or bolt isutilized as the positioning means 1002, any type of screw head isacceptable even though the exemplary screw slot shown in FIG. 10requires the use of an allen wrench. Slotted, Phillips, Pozidriv, Torx,Robertson, Tri-Wing, Torq-Set, Spanner and any other heads areacceptable alternatives. Also located within the first end face 1018 areone or more apertures 1016 to allow bone graft material to contact thevertebral bone after the device 1000 has been inserted between thevertebrae of the patient. The holes 1014 within the tabs 1006 alsopermit the insertion of bone graft material.

FIG. 11 illustrates a top/side perspective view of the bone fusiondevice 1000 in some embodiments. As described before, the bone fusiondevice 1000 utilizes the positioning means 1002 to move the extendingblock 1010 up and down the body of the positioning means 1002 whichforces the tabs 1006 to either extend or retract depending on theposition of the extending block 1010. When the extending block 1010 islocated near the head of the positioning means 1002, the extending block1010 forces the tabs 1006 outward so that the tabs 1006 are extendedbeyond the frame 1000 to secure the bone fusion device 1000 in place.However, when the extending block 1010 is located away from the head ofthe positioning means 1002, the tabs 1006 are situated within the frame1004, making the bone fusion device 1000 very compact. Opposing the endof the head of the positioning means is the second end face 1020 whichcontains an opening 1012 for providing access to a cavity within theinterior of the bone fusion device 1000. In some embodiments, bone graftmaterials, such as the bone chips and/or the synthetic bone matrix thatwere mentioned above, are pre-loaded into the cavity within the bonefusion device 1000 through the opening 1012. The other holes 1014 withinthe tabs allow the bone graft material to contact the vertebral boneafter the device 1000 has been inserted between the vertebrae of thepatient.

FIG. 12 illustrates a section of a vertebral column showing the bonefusion device 1000 inserted between two adjacent vertebrae 330 and 335in place of an intervertebral disc. As shown in this figure, the bonefusion device 1000 is positioned in a location where an intervertebraldisc would normally reside. A flexible disc is typically sandwichedbetween the two vertebrae of a normal healthy spinal column. Forinstance, the normal, healthy disc 340 is sandwiched between thevertebrae 337 and 330. However, for the spinal column illustrated inFIG. 12 , the intervertebral disc that normally resides between thevertebrae 330 and 335 has been excised and surgical insertion of thebone fusion device 1000 has replaced the disc as the supportingstructure between the vertebrae 330 and 335.

During the insertion and placement of the bone fusion device 1000, thetabs 1006 are deposed in a position aligned along the body of the bonefusion device 1000, such that the tabs lie substantially within theexterior surfaces of the device. In some embodiments, the tabs 1006 areflush with the exterior surface. In these embodiments, the form factorof the bone fusion device 1000 is configured to be as compact aspossible. For example, the form factor of some embodiments has adiameter of approximately 0.28 inches and a length of approximately 1.0inch. In contrast, the form factor of these same embodiments has adiameter of approximately 0.48 inches when the tabs 1006 are fullyextended. In other embodiments the size could be larger or smaller asneeded.

By minimizing the space occupied, the bone fusion device 1000 isadvantageously inserted arthroscopically into the patient's body. Ifinstead, the device 1000 were inserted in its fully extended form, alarger surgical incision would be required, and a greater displacementof the muscles and nerves would be needed. However, its compact formfactor allows the bone fusion device 1000 to be inserted byadvantageously utilizing minimally invasive arthroscopic techniques.Then, the tabs 1006 of the bone fusion device 1000 are extended afterarthroscopic insertion to optimally increase the form factor and bracethe device 1000 between the vertebrae 330 and 335.

FIG. 13 illustrates a side view of another embodiment of the bone fusiondevice 1000′. The bone fusion device 1000′ utilizes the positioningmeans 1002 to move the extending block 1010 (FIG. 9 ) up and down thebody of the positioning means 1002 which forces the tabs 1006′ to eitherextend or retract depending on the position of the extending block 1010(FIG. 9 ). The tabs 1006′ have serrated edges 1026 to further increasethe bone fusion device's gripping ability to secure it in place betweenthe bones. When the extending block 1010 (FIG. 9 ) is located near thehead of the positioning means 1002, the extending block 1010 (FIG. 9 )forces the tabs 1006′ outward so that the tabs 1006′ are extended beyondthe frame 1000 to secure the bone fusion device 1000 in place. The tabs1006′ are each coupled to the frame 1004 of the bone fusion device 1000′by one or more slots 1028 and one or more pins 1024 wherein the one ormore pins 1024 fit within the one or more slots 1028 and are able totravel along the interior of the one or more slots 1028. When theextending block 1010 (FIG. 9 ) is located away from the head of thepositioning means 1002, the tabs 1006′ are situated within the frame1004, making the bone fusion device 1000′ very compact. The holes 1014within the tabs allow the bone graft material to contact the vertebralbone after the device 1000′ has been inserted between the vertebrae ofthe patient.

FIG. 14A illustrates a cross sectional view of the bone fusion device1000′ with the tabs 1006′ with serrated edges 1026 compacted in anotherembodiment. When the extending block 1010 is positioned away from thehead of the positioning means 1002 and close to the second end face 1020(FIG. 11 ), the tabs 1006′ are positioned within the frame 1004 of thebone fusion device 1000′. The tabs 1006′ are coupled to the frame 1004of the bone fusion device by the one or more slots 1028 and the one ormore pins 1024 wherein the one or more pins 1024 fit within the one ormore slots 1028 and are able to travel along the interior of the one ormore slots 1028.

FIG. 14B illustrates a cross sectional view of the bone fusion device1000′ with the tabs 1006′ with serrated edges 1026 extended in anotherembodiment. When the extending block 1010 is positioned near the head ofthe positioning means 1002 and close to the first end face 1018 (FIG. 10), the tabs 1006′ extend beyond the frame 1004 of the bone fusion device1000′ and ultimately secure the bone fusion device 1000′ between twobones. The tabs 1006′ extend because the extending block 1010 pushes theangled tabs 1006 outwardly as shown by the arrows 1022. The position ofthe extending block 1010 is changed by rotating the positioning means1002 either clockwise or counterclockwise. The tabs 1006′ are extendedoutward due to the force of the extending block 1010. With the tabs1006′ coupled to the frame 1004 of the bone fusion device by the one ormore slots 1028 and the one or more pins 1024, the tabs 1006′ are ableto extend beyond the frame of the bone fusion device 1000′ as the one ormore pins 1024 travel within the interior of the one or more slots 1028.

Alternatively, the bone fusion device includes one or more pivots or anyother rotating means that allows movement of the tabs wherein the one ormore pivots are located at either end of the tabs.

To utilize the bone fusion device is some embodiments, it is initiallyconfigured in a compact position such that the extending block islocated away from the head of the positioning means and towards thesecond end face thereby allowing the tabs to rest within the frame ofthe bone fusion device. The compact bone fusion device is then insertedinto position within the patient. The surgeon is able to then the expandthe bone fusion device by rotating the positioning means which moves theextending block towards the head of the positioning means and the firstend face. As the extending block moves closer to the first end face, thetabs are pushed outwardly from the pressure of the extending blockagainst the angled tabs. Eventually the extending block moves closeenough to the first end face causing enough pressure between theextended tabs and the bones to be fused. At that point the bone fusiondevice is able to remain in place. Thereafter, material for fusing thebones together is inserted through the holes and openings within thebone fusion device.

FIG. 15 illustrates a top perspective view of the bone fusion device inthe preferred embodiment of the invention. As shown in this figure, thebone fusion device 1500 has a substantially rectangular shape and hastwo end faces. The bone fusion device 1500 is preferably constructedfrom a high strength biocompatible material, such as titanium, which hasthe strength to withstand compressive and shear forces in the spine thatare generated by a patient's body weight and daily movements. The basebiocompatible material is often textured or coated with a porousmaterial conducive to the growth of new bone cells on the bone fusiondevice 1500. The bone fusion device 1500 has several conduits or holes1520 (FIG. 16 ) and 1534 which permit the bone graft material to contactthe vertebral bone after the device 1500 has been inserted between thevertebrae of the patient. The bone graft material and the surfacetexturing of the device 1500 encourage the growth and fusion of bonefrom the neighboring vertebrae. The fusion and healing process willresult in the bone fusion device 1500 becoming embedded within the twoadjacent vertebrae of the spine which eventually fuse together duringthe healing period. In some embodiments, the bone fusion device 1500comprises a radio frequency identification (RFID) chip 1501 thatuniquely identifies the bone fusion device 1500, provides informationabout the characteristics of the bone fusion device 1500, providesinformation about the patient in which the bone fusion device 1500 isimplanted, provides information about the procedure used to implant thebone fusion device 1500 and/or other types of information. In someembodiments, the RFID chip 1501 is passive. Alternatively, the RFID chip1501 is active. As a result, the bone fusion device 1500 is able toprovide the benefit of enable the RFID chip 1501 to be scanned and theinformation contained on the chip 1501 to be accessed for beneficialuse.

As further illustrated in FIG. 15 , tabs 1530 are located on opposingsides of the bone fusion device 1500. The tabs 1530 are shaped so thattheir outer surface is substantially flush with the frame 1514 of thebone fusion device 1500 in a nonextended position. Internally, the tabs1530 have an angled inner surface. Each tab 1530 is shaped such that theends are larger than the middle, and the size of the tab 1530 graduallyincreases while going from the middle to the ends. A positioning means1508 within the frame 1514 of the bone fusion device 1500 comprises afirst screw 1502 and a second screw 1504 coupled together. The firstscrew 1502 is threaded opposite of the second screw 1504. For example,if the first screw 1502 is left threaded, the second screw 1504 is rightthreaded or visa versa. Furthermore, the first screw 1502 is of aslightly different size than the second screw 1504. The positioningmeans 1508 is coupled to a first extending block 1510 and a secondextending block 1512. Specifically the first extending block 1510 iscoupled to the first screw 1502 and the second extending block 1512 iscoupled to the second screw 1504. The first extending block 1510 and thesecond extending block 1512 are positioned in the middle of the bonefusion device 1500 in the compact position. When the positioning means1508 is turned appropriately, the extending blocks 1510 and 1512 eachtravel outwardly on their respective screws 1502 and 1504. As theextending blocks 1510 and 1512 travel outwardly, they push the tabs 1530outward. To retract the tabs 1530, the positioning device 1508 is turnedin the opposite direction and the extending blocks 1510 and 1512 willeach travel back to the middle on their respective screws 1502 and 1504.When the extending blocks 1510 and 1512 are positioned in the middle ofthe bone fusion device 1500, the tabs 1530 are compact and are withinthe frame 1514 of the bone fusion device 1500. Thus, the nonextendedtabs 1530 of the bone fusion device 1500 provide a compact assembly thatis suitable for insertion into the patient's body through anarthroscopic surgical procedure. An arthroscopic procedure is consideredminimally invasive and has certain advantages over more invasiveconventional surgical procedures. In an arthroscopic procedure, asmaller surgical incision is employed as compared to the size of theincision required for conventional invasive surgery. Moreover,arthroscopic procedures minimize or eliminate the need for excessiveretraction of a patient's tissues such as muscles and nerves, therebyminimizing trauma and injury to the muscles and nerves and furtherreducing the patient's recovery time.

As the positioning means 1508 is rotated causing the extending blocks1510 and 1512 to move closer to the ends of the respective screws 1502and 1504, the extending blocks 1510 and 1512 push the tabs 1530 outwardcausing the tabs 1530 to assert pressure against surrounding bones andsecuring the bone fusion device 1500 in place. When the extending blocks1510 and 1512 reach as close to the head of the positioning means 1508as allowed, the tabs 1530 are fully extended. Furthermore, since theextending blocks 1510 and 1512 travel along the positioning means 1508,along the threads of the screws 1502 and 1504, very precise positions ofthe tabs 1530 are able to be achieved. The tabs 1530 have serrated edges1536 to further increase the bone fusion device's gripping ability tosecure it in place between the bones.

To secure the bone fusion device 1500 in place, a user generallyutilizes an implement such as a screw driver to turn the positioningmeans 1508. Screw drivers unfortunately have the ability to slip out ofplace. When performing surgery near someone's spine, it is preferable toprevent or at least minimize the slipping ability. To do so, channels1522 are implemented to receive a tool (not shown). The tool (not shown)has attachments that fit within the channels 1522 to secure the tool(not shown) in place.

FIG. 16 illustrates a side perspective view of the bone fusion device inthe preferred embodiment of the present invention. The bone fusiondevice 1500 utilizes the positioning means 1508 comprising the firstscrew 1502 and the second screw 1504 to move the first extending block1510 and the second extending block 1512 outwardly from the middle ofthe bone fusion device 1500 towards its ends. The positioning means 1508is held in place but permitted to turn utilizing one or more first pins1516. The one or more first pins 1516 are secured within a retaininggroove 1506 (FIG. 17 ) of the positioning means 1508. The extendingblocks 1510 and 1512 force the tabs 1530 to either extend or retractdepending on where the extending blocks 1510 and 1512 are positioned. Asdescribed above, the tabs 1530 have serrated edges 1536 to furtherincrease gripping ability. The tabs 1530 are each coupled to the frame1514 of the bone fusion device 1500 by one or more slots 1532 (FIG. 18A)and one or more second pins 1518 wherein the one or more second pins1518 fit within the one or more slots 1532 and are able to travel alongthe interior of the one or more slots 1532. The holes 1534 within thetabs 1530 allow the bone graft material to contact the vertebral boneafter the device 1500 has been inserted between the vertebrae of thepatient. A set of holes 1520 within the frame 1514 also allow bone graftmaterial to be inserted within the bone fusion device 1500 after thebone fusion device 1500 has been placed. The channels 1522 implementedto receive a tool are shown as well.

FIG. 17 illustrates a cross-sectional view of components of the bonefusion device in the preferred embodiment of the present invention. Asdescribed above, the positioning means 1508 comprises a first screw 1502and a second screw 1504 wherein the first screw 1502 is threadeddifferently than that of the second screw 1504. Furthermore, the firstscrew 1502 is of a slightly different size than the second screw 1504.For example, the first screw 1502 is an 8-32 screw and the second screwis a 6-32 screw. A retaining groove 1506 is utilized to secure thepositioning means 1508 in place. To ensure that a device (not shown)does not slip while turning the positioning means 1508, channels 1522are utilized to secure the device. A first extending block 1510 and asecond extending block 1512 are utilized with the positioning means 1508to extend and compact a plurality of tabs 1530. The first extendingblock 1510 has an internal opening to fit around the first screw 1502.The second extending block 1512 has an internal opening to fit aroundthe second screw 1504. The frame 1514 of the bone fusion device 1500contains a set of holes 1520 within the frame 1514 for allowing bonegraft material to be inserted. Furthermore, one or more first pins 1516secure the positioning means within the frame 1514. One or more secondpins 1516 in conjunction with one or more slots 1532 secure the tabs1530 to the frame 1514.

FIG. 18A illustrates a cross sectional view of the bone fusion devicewith the tabs compacted in the preferred embodiment of the invention.When the extending blocks 1510 and 1512 are positioned in the middle ofthe positioning means 1508 with the first screw 1502 and the secondscrew 1504, the tabs 1530 are positioned within the frame 1514 of thebone fusion device 1500. The positioning means 1508 contains a retaininggroove 1506 for holding the positioning means 1508 in place with one ormore first pins 1516. The tabs 1530 are coupled to the frame 1514 of thebone fusion device 1500 using the one or more slots 1532 and the one ormore second pins 1518 wherein the one or more second pins 1518 fitwithin the one or more slots 1532 and are able to travel along theinterior of the one or more slots 1532.

FIG. 18B illustrates a cross sectional view of the bone fusion devicewith the tabs extended in the preferred embodiment of the invention. Asshown in FIG. 18A, the bone fusion device 1500 is compressed when theextending blocks 1510 and 1512 are in the middle of the bone fusiondevice 1500. As a user turns the positioning means 1508, the extendingblocks 1510 and 1512 gradually move outward from the middle. If the userturns the positioning means 1508 in the opposite direction, theextending blocks move back towards the middle. As the extending blocks1510 and 1512 are moving outward, they push on the tabs 1530. The tabs1530 extend because the extending blocks 1510 and 1512 exert force theangled tabs 1530 outwardly as shown by the arrows 1540. When theextending blocks 1510 and 1512 are positioned near the ends of the bonefusion device 1500, the tabs 1530 extend beyond the frame 1514 of thebone fusion device 1500 and ultimately secure the bone fusion device1500 between two bones. With the tabs 1530 coupled to the frame 1514 ofthe bone fusion device 1500 by the one or more slots 1532 and the one ormore second pins 1518, the tabs 1530 are able to extend beyond the frame1514 of the bone fusion device 1500 as the one or more second pins 1518travel within the interior of the one or more slots 1532.

To utilize the bone fusion device in the preferred embodiment, it isinitially configured in a compact position such that the extendingblocks are located in the middle of the bone fusion device therebyallowing the tabs to rest within the frame of the bone fusion device.The compact bone fusion device is then inserted into position within thepatient. The surgeon is able to then the expand the bone fusion deviceby rotating the positioning means which moves the extending blockstowards the opposing ends of the bone fusion device—one near the head ofthe positioning means and the other towards the tail of the positioningmeans. As the extending blocks move away from the middle, the tabs arepushed outwardly from the pressure of the extending block against theangled tabs. Eventually the extending blocks exert a satisfactory forcebetween the extended tabs and the bones to be fused. At that point thebone fusion device is able to remain in place. Thereafter, material forfusing the bones together is inserted through the holes and openingswithin the bone fusion device.

FIG. 19 illustrates a perspective view of a bone fusion device 1900having one or more stops according to some embodiments. The bone fusiondevice 1900 shown in FIG. 19 is substantially similar to the bone fusiondevice 1500 except for the differences described herein. Specifically,instead of the pin and slot system of the bone fusion device 1500, thebone fusion device 1900 comprises a body 1902 having one or morerecesses 1908 and one or more tabs 1904 having one or more stops 1906.As shown in FIG. 19 , the tabs 1904 each comprise five stops 1906positioned along the bottom perimeter of the tabs 1904. However, it isunderstood that the tabs 1904 are each able to comprise any number ofstops 1906 positioned anywhere along the perimeter of the tabs 1904. Therecesses 1908 are sized and positioned within the body 1902 such thatthe recesses 1908 are each able to receive at least one of the stops1906 when the tabs 1904 are inserted into the body 1902. In particular,once within the recesses 1908, the stops 1906 are able to slide up anddown the recesses 1908 as the tabs 1904 are extended out and retractedwithin the body 1902. In this way, the recesses 1908 are able to beconfigured to block the outward/extension movement of the stops 1906 ata desired maximum extension point thereby preventing the tabs 1904 fromextending beyond the maximum extension point and/or falling out of thebody 1902. In some embodiments, each stop 1906 has a separate associatedrecess 1908 such that there is one recess 1908 for each stop 1906.Alternatively, as shown in FIG. 19 , one or more of the stops 1906 areable to share a single recess 1908′.

FIG. 20 illustrates a frontal view of a tab 1904 having one or morestops 1906 according to some embodiments. Specifically, as shown in FIG.20 , the stops 1906 comprise a stop outer surface 1912 that is angledwith respect to the surface of the perimeter of the tab 1904 such thatthe lower portion of the stop 1906 is closer to the perimeter of the tab1904 than the upper portion of the stop 1906. As a result, the stopouter surface 1912 is able to facilitate the insertion of the tabs 1904into the body 1902 by causing the tab 1904 to compress when entering theopening of the body 1902 and then decompress as the stops 1906 slideinto the recesses 1908 within the body 1902. In some embodiments, one ormore of the stops 1906 comprise a stop channel 1910 than enables thestops 1906 to flex inwardly when the tab 1904 is inserted into the body1904 and spring back into place when the stops 1906 align with therecesses 1908. Additionally, in some embodiments the stop channel 1910is able to be sized to receive a retention spring 2106 (see FIG. 21 ) inorder to facilitate the coupling of the tab 1904 with the retentionspring 2106. In such embodiments, the stops 1906 are able to replace orsupplement the tab protrusions 2108. Accordingly, the bone fusion device1900 provides the advantage of better securing the tabs 1904 within thebody 1902 of the device 1900. Also, it is understood that thedifferences to the bone fusion device 1900 described in FIGS. 19 and 20are able to be incorporated with and/or replace components of each ofthe other bone fusion devices described herein.

FIGS. 21A-21J illustrate views of a bone fusion device 2100 having oneor more retention springs according to some embodiments. The bone fusiondevice 2100 shown in FIGS. 21A-21J is substantially similar to the bonefusion device 1500 except for the differences described herein. Further,it is understood that although FIGS. 21A-21J illustrate a number of tabsand retention springs, any number of tabs and retention springs arecontemplated. FIGS. 21A and 21B illustrate side cross-sectional views ofa bone fusion device 2100 having tabs in the contracted and extendedpositions, respectively. As shown in FIGS. 21A and 21B the bone fusiondevice 2100 comprises a body 2102 having one or more spring receptors2110, one or more tabs 2104 having tab protrusions 2108 and one or moreretention springs 2106. In some embodiments, the retention springs 2106comprise a wire such as a nitinol wire. Alternatively, the retentionsprings 2106 are able to comprises other dimensions and/or materials asare well known in the art. In some embodiments, the device 2100comprises at least one retention spring 2106 for each tab 2104.Alternatively, a single retention spring 2106 is able to contact and/orbe coupled to multiple tabs 2104. The ends of the retention springs 2106are positioned and/or coupled within the spring receptors 2110 such thatthe ends of the retention springs 2106 do not move with respect to thebody 2102. The middle of the retention springs 2106 is coupled to and/orpositioned such that it blocks the outward movement of the tabprotrusions 2108 of each of the tabs 2104 in order to resist themovement of the tabs 2104 into the extended position. As shown in FIG.21B, when a user causes the tabs 2104 and their corresponding tabprotrusions 2108 move/extend out of the body 2102, the protrusions 2108cause the retention springs 2106 to flex. As a result, the resistance tothis flexure by the retention springs 2106 biases the tabs 2104 towardthe retracted position such that when the user retracts the tabs 2104they do not get stuck in the extended position. Thus, the bone fusiondevice 2100 provides the benefit of ensuring that the tabs 2104 retractproperly when retracted from an extended position.

As shown FIGS. 21A and 21B, the each retention spring 2106 iscoupled/associated with a single tab 2104 and/or tab protrusion 2108.Alternatively, as shown in FIG. 21C, the bone fusion device 2100 is ableto comprise a single continuous retention spring 2106 that couples withmultiple tabs 2104 and/or tab protrusions 2108. In some embodiments, asshown in FIG. 21D, the tab protrusions 2108 each comprise a protrusionchannel 2112 that is configured for receiving the retention springs2106. As a result, the channels 2112 are able to ensure that theretention springs 2106 do not slip off of the protrusions 2108 duringoperation. In some embodiments, as shown in FIG. 21E, the tabprotrusions 2108 comprise one or more protrusion apertures 2114 that areconfigured to receive the retention springs 2106. As a result, theprotrusion apertures 2114 enable the retention springs 2106 to besecured to the tab protrusions 2108.

FIG. 21F illustrates a side cross-sectional view of the bone fusiondevice 2100 having one or more retention springs according to someembodiments. As shown in FIG. 21F, instead of coupling between the body2102 of the device 2100 and the tab protrusions 2108, the retentionsprings 2106 of FIG. 21F are coupled between a tab protrusion 2108 of afirst tab 2104 and the tab protrusion 2108 of a second tab 2104. As aresult, the resistance provided by the retention springs 2106 in orderto bias the tabs 2104 into the retracted position is able to beincreased as the retention springs 2106 are flexed in both directions bythe oppositely moving tabs 2104.

FIG. 21G illustrates a side cross-sectional view of the bone fusiondevice 2100 having one or more retention springs according to someembodiments. As shown in FIG. 21G, instead of tab protrusions 2108and/or spring receptors 2110, the bone fusion device 2100 comprises tabs2104 having tab channels 2116 and one or more ring or looped retentionsprings 2106. Specifically, the ring or looped retention springs 2106are able to be wrapped around the tabs 2104 one or more times in orderto bias the tabs 2104 in the retracted position. Further, the tabchannels 2116 are able to be configured to receive at least a portion ofthe ring or looped retention springs 2106 in order to prevent thesprings 2106 from sliding off and/or moving with respect to the tab2104. Although a single ring or looped retention spring 2106 loopedaround the tabs 2104 once is shown in FIG. 21G, any number of retentionsprings 2106 looped any number of times is contemplated.

FIG. 21H illustrates a perspective view and FIGS. 21I and 21J illustratecross-sectional side views of the bone fusion device 2100 wherein theretention springs are incorporated into the body according to someembodiments. As shown in FIGS. 21H-21J, the body 2102 comprises aplurality of wall cavities 2116, 2116′ wherein the retention springs2106, 2106′ are coupled to the body 2102 and positioned within the wallcavities 2116, 2116′. Specifically, the tab protrusions 2108 areconfigured to fit within the wall cavities 2116, 2116′ below theretention springs 2106, 2106′ such that, as shown in FIGS. 21I and 21J,when a user moves the tabs 2104 into an extended position, the retentionsprings 2106, 2106′ are flexed within the wall cavities 2116, 2116′causing the springs 2106, 2106′ to apply an opposite biasing force. Thisbiasing force ensures that the tabs 2104 properly retract when a usermanipulates the bone fusion device 2100 in order to retract the tabs2104. In some embodiments, the retention springs 2106 are continuoussuch that the retention spring 2106 continues from a connection to thebody 2102 on one side of the cavity 2116 to a connection to the body2102 on the opposite side of the cavity 2116. Alternatively, one or moreof the retention springs 2106′ are able to be discontinuous such thattwo or more separate retention springs 2106′ couple to the oppositesides of the cavity 2116′ of the body 2102 and meet approximately in themiddle of the cavity 2116′. In either case, the retention springs 2106,2106′ are configured, positioned and coupled within the cavities 2116,2116′ such that they bias the tabs 2104 in the retracted position. As aresult, the bone fusion device 2100 of FIGS. 21H-21J provides theadvantage of ensuring the tabs 2104 are able to be properly retractedvia biasing using retention springs. In some embodiments, the retentionsprings 2106 comprise PEEK or PEEKsil. Alternatively, the retentionsprings 2106 are able to comprise other bio-compatible materials withspringing properties as are well known in the art. It is understood thatthe differences to the bone fusion device 2100 described in FIGS.21A-21J are able to be incorporated with and/or replace components ofeach of the other bone fusion devices described herein.

FIGS. 22A-22G illustrate views of a bone fusion device 2200 having oneor more tabs with telescoping levels according to some embodiments. Thebone fusion device 2200 shown in FIGS. 22A-22G is substantially similarto the bone fusion device 1500 except for the differences describedherein. Further, it is understood that although FIGS. 22A-22G illustratea number of tabs with telescoping levels, any number of tabs with anynumber of telescoping levels is contemplated. FIGS. 22A-22D illustrateside, top, exploded side and bottom cross-sectional views of a bonefusion device 2200 having one or more tabs with telescoping levelsaccording to some embodiments. As shown in FIGS. 22A-22D, the bonefusion device 2200 comprises a body 2202, one or more tabs 2204 eachhaving a plurality of tab levels 2206, 2206′, one or more positioningelements 2208 and one or more extending blocks 2210. As shown in FIG.22B, the levels 2206, 2206′ of each tab 2204 are nested such that aninnermost level 2206′ is surrounding by one or more outer levels 2206.Alternatively, the outer levels 2206′ are able to be positioned adjacentto but not surrounding the relatively inner levels 2206, 2206′.

As shown in FIGS. 22C and 22D, each of the levels 2206, 2206′ have aninner surface 2211, 2211′ having an inner surface profile 2212, 2212′that is contoured in a manner that controls the extension and retractionof the associated level 2206, 2206′ when pushed by the extending blocks2210. In some embodiments, as shown in FIGS. 22C and 22D, the innersurface profiles 2212, 2212′ and/or the extending blocks 2210 are ableto be configured such that as the extending blocks 2210 separate boththe innermost and outer level 2206, 2206′ simultaneously extend to afirst extended height beyond which the outer level 2206 stops and theinnermost level 2206′ continues to extend to a second extended height.Conversely, when the extending blocks 2210 are moved closer together,the innermost level 2206′ retracts from the second extended height tothe first extended height beyond which both the innermost and the outerlevels 2206, 2206′ simultaneously retract until in the retractedposition. Alternatively, the inner surface profiles 2212, 2212′ and/orthe extending blocks 2210 are able to be configured such that each ofthe innermost and outer levels 2206, 2206′ move simultaneously orseparately to any desired heights when the extending blocks 2210 areseparated/moved together. In particular, each level 2206, 2206′ is ableto have a differently contoured inner surface 2211, 2211′ having aninner surface profile 2212, 2212′ that aligns with a differently angledand/or sized extending block surface such that the movement of eachlevel 2206, 2206′ is individually customizable. As a result, the bonefusion device 2200 provides the benefit of enabling the tab levels toextend in a telescoping or other type of extending action to variousheights and at various rates as desired. This is able to be used toachieve desired extension heights as well as to provide increasedlateral support to the innermost level 2206′ when extended to themaximum extended position due to the support provided to the innermostlevel 2206′ by the outer levels 2206 positioned at less than maximumextended positions.

FIGS. 22E and 22F illustrate an exploded side and a top view of the bonefusion device 2200 having nested tab levels with tongues according tosome embodiments. As shown in FIGS. 22E, the extending blocks 2210comprise a plurality of upper surfaces 2218, 2220 at different heightsand/or angles. In particular, as shown in FIG. 22G which illustrates aperspective view of a extending block 2210 according to someembodiments, the extending block 2210 comprises a plurality of rows 2219that each correspond to one or more of the inner surfaces 2211, 2211′ ofthe levels 2206, 2206′, wherein each row 2219 is able to have adifferent height and/or angle that corresponds to the correspondinginner surfaces 2211, 2211′ in order to control the manner in which thelevels 2206, 2206′ are extended/retracted by the device 2200. In someembodiments, as shown in FIGS. 22E and 22G, the blocks 2210 are able tocomprise a raised upper surface 2220 that is centered and corresponds tothe profile 2212′ of the innermost level 2206′ and one or more lowerupper surfaces 2218 that are off-center and correspond to the profile2212 of the outer level 2206. Alternatively, as shown in FIGS. 22A and22C above, one or more of the extending blocks 2210 are able to comprisea single row having a constant height and/or angle.

As shown in FIGS. 22E and 22F, the innermost tab level 2206′ comprisesone or more tongues 2216 that extend over the outer levels 2206 and/orthe body 2202. Specifically, the outer levels 2206 and/or the body 2202comprise one or more notches 2214 that are configured to receive thetongues 2216 of the innermost tab level 2206 such that in the retractedposition that tongues 2216 slide within the notches 2214 in order tominimize the size of the bone fusion device 2200. Further, as a resultof the tongues 2216, when the innermost level 2206′ is extended furtherthan one or more of the body 2202 and/or the outer levels 2206, theinnermost level 2206′ is able to obtain the benefit of an increased topsurface area for contacting and fusing to the bone. Moreover, thetongues 2216 provide the benefit of enabling the extending of the outerlevels 2206 to simultaneously extend the innermost level 2206′ becauseas the outer levels 2206 are extended they push up the tongues 2216 ofthe innermost level 2206′ thereby raising the levels 2206, 2206′simultaneously. As a result, the inner surface profile 2212′ of theinnermost level 2206′ does not need to be configured until the outerlevels 2206 have reached their most extended height. For example, asshown in FIG. 22E, the middle portion of the inner surface profile 2212of the outer level 2206 is able to be configured to extend both theinner and outer levels 2206, 2206′ and the thus only the outer portionof the inner surface profile 2212′ of the innermost level 2206′ needs tobe configured to extend the innermost level 2206′ beyond that point. Asshown in FIG. 22G, the tongues 2216 and corresponding notches 2214 areable to extend over the body 2202 and all the outer levels 2206 orextend over less than the body 2202 and/or one or more of the outerlevels 2206. Additionally, the tongues 2216 are able to each havedifferent widths, lengths and heights, and be positioned anywhere alongthe perimeter of the innermost level 2206′. It is understood that thedifferences to the bone fusion device 2200 described in FIGS. 22A-22Gare able to be incorporated with and/or replace components of each ofthe other bone fusion devices described herein.

FIG. 23 illustrates a flow chart of a method of implanting a telescopingbone fusion device between bones according to some embodiments. A userpre-configures the one or more moveable tabs 2204 of the telescopingbone fusion device 2200 to the retracted position with the positioningelement 2208 and the plurality of extending blocks 2210 such that thebone fusion device 2200 has a minimized form factor at the step 2302.The user inserts the telescoping bone fusion device 2200 in between thebones at the step 2304. The user telescopically extends the nestedlevels 2206, 2206′ of the tabs 2204 until one or more of the levels2206, 2206′ contact the bones at the step 2306. In some embodiments,each of the nested levels 2206, 2206′ of each tab 2204 has a maximumextended position that is different than the maximum extended positionof the other nested levels 2206, 2206′ of the tabs 2204. In someembodiments, the distance from the body of the maximum extended positionfor each of the nested levels 2206, 2206′ of each tab 2204 increasesfrom the outermost nested level 2206 to the innermost nested level2206′. In some embodiments, the telescopically extending comprisesmoving one or more extending blocks 2210 with a positioning element 2208such that the extending blocks 2210 push against the inner surfaceprofile 2212, 2212′ of one or more of the nested tab levels 2206, 2206′.In some embodiments, the innermost nested level 2206′ of each tab 2204comprises one or more tongues 2216 that extend from the top surface ofthe innermost nested level 2206′ to the perimeter of the tab 2204. Insome embodiments, the non-innermost nested levels 2206 of each tab 2204comprise one or more recesses 2214 that align with the one or moretongues 2216 such that when the innermost nested level 2206′ is nestedwithin one or more of the non-innermost nested levels 2206 the tongues2216 slide within the recesses 2214. As a result, the method is able toprovide the benefits of a minimally invasive surgery due to theminimized form factor of the telescoping bone fusion device in theretracted position and a more stable bone fusion device with increasedextension due to the telescoping and intermediate extensions of thenested tab levels.

FIG. 24 illustrates a perspective view of a distraction instrument 2400for measuring the space to be filled by a bone fusion device accordingto some embodiments. As shown in FIG. 24 , the distraction instrument2400 comprises a distraction body 2402 and a distraction head 2402operably coupled together. FIG. 25 illustrates a top cross sectionalview of the distraction body 2402 according to some embodiments. Asshown in FIG. 25 , the distraction body 2402 comprises a handle 2502, aengaging element 2504 and a guide element 2506. The handle 2502 iscoupled with the engaging element 2504 which is positioned within theguide element 2506 such that a user is able to rotate, push and/or pullthe handle 2502 in order to rotate, extend and/or retract the engagingelement 2504 within or further out of the guide element 2506. In someembodiments, the handle 2502 and/or guide element 2506 comprise one ormore gripping ridges enabling a user to rotate or otherwise move thehandle 2502 with respect to the guide element 2506 without slipping. Insome embodiments, the instrument 2400 is able to comprise an electricmotor and control interface (not shown) such that the movement of thehandle 2502 is able to be effectuated by a user controlling theoperation of the electric motor via the control interface. In someembodiments, the guide element 2506 comprises one or more a stop pins2510 that couple to the stop apertures 2617 of the rear fitting 2614 ofthe rear jack assembly 2604 (see FIG. 26 ). When coupled within the stopapertures 2617, the stop pins 2510 are able to prevent the distractionhead 2402 from rotating with the engaging element 2504 as well askeeping the rear fitting 2614 of the rear jack assembly 2604 abut theend of the guide element 2506. In some embodiments, the engaging element2504 comprises a threaded portion 2512 positioned along the end of theengaging element 2504 such that the threaded portion 2512 is able tooperably coupling with the threads 2618 of the front fitting 2615 of thefront jack assembly 2606 (see FIG. 26 ). As a result, when the engagingelement 2504 is rotated, the threaded portion 2512 is able to engage thethreads 2618 of the front fitting 2615 causing the front fitting 2615 toslide toward or away from the rear fitting 2614. Alternatively, thethreaded portion 2512 and the threads 2618 are able to be omitted andthe end of the engaging element 2504 is able to be coupled to the frontfitting 2615 such that when the engaging element 2504 is pulled into orpushed out of the guide element 2506 the coupling causes the frontfitting 2615 to also slide toward or away from the rear fitting 2614.Alternatively, the threaded portion 2512 is a female thread such thatwhen the engaging element 2504 is rotated, the threading 2512 causes theengaging element 2504 to retract into the guide element 2506 and thefront fitting 2615 to slide toward the rear fitting 2614. In suchembodiments, the threading 2512 is able to be positioned in other placesalong the engaging element 2504.

In some embodiments, one or more of the handle 2502, engaging element2504 and/or the guide element 2506 comprise one or more indicators 2508that indicate values corresponding to the current separation between theplates 2602 of the head 2404 (see FIG. 26 ). In some embodiments, theindicators 2508 comprise first markings on the visually exposed surfaceof the engaging element 2504 and/or handle 2502 that move relative tocorresponding second markings on the guide element 2502 when theengaging element 2504 is rotated or otherwise moved. As a result, basedon the alignment of the first and second markings the current separationbetween the plates 2602 of the head 2404 is able to be determined.Alternatively, the indicators 2508 are able to comprise a digital oranalog readout/display that indicates the current level of distractionof the instrument 2400. In some embodiments, the motion of the handle2502 is effectuated by an electrical motor and the indicators 2508 areable to include the control interface for controlling the operation ofthe electrical motor. Alternatively, other types of indicating elements2508 corresponding to the current separation of the plates 2602 are ableto be used as are well known in the art.

In some embodiments, the indicators 2508 indicate a number ofrevolutions or rotations that the positioning element of a bone fusiondevice will require in order to extend the tabs to the height indicatedby the separation of the plates 2602. For example, in some embodimentsthe a user is able to input or the instrument 2400 is able to bepre-programmed with the type of bone fusion device to be used and basedon this data, the indicators 2508 are able to indicate the number ofrotations/revolutions that the positioning element of a bone fusiondevice will require in order to extend the tabs to the height indicatedby the separation of the plates 2602. In some embodiments, based on thedetermined current separation of the plates 2602, the indicators 2508are able to indicate a recommended size and/or type of bone fusiondevice to be used for filling the measured space. As a result, thedistraction instrument 2400 provides the advantage of indicating thebest type/size of bone fusion device to use and/or the exact amount ofrotation needed to a user of a bone fusion device such that the userdoes not overextend the tabs of the bone fusion device.

In some embodiments, the instrument 2400 comprises a force measurementcomponent (not shown) and/or the indicators 2508 indicate the amount offorce on the plates 2602 that is resisting the expansion/distraction ofthe plates 2602. In such embodiments, the distraction instrument 2400 isable to be configured to prevent the user from furtherextending/distracting the plates 2602 when a predefined and/oradjustable force threshold value is detected by the force measurementcomponent. For example, if the distraction is effectuated by anelectronically controlled motor the distraction system is able to beconfigured to automatically stop when the force threshold value isdetected. Alternatively, the force measurement component is able to beimplemented mechanically such that the components of the instrument 2400that effectuate the distraction of the plates 2602 prevent furtherdistraction when a predetermined and/or adjustable amount of resistanceis present. As a result, the distraction instrument 2400 provides thebenefit of enabling a user to manually stop, automatically stoppingand/or preventing the user for continuing to distract the plates 2602when the force measurement component and/or indicators 2508 indicatethat a predetermined amount of expansion resistant force is detected onthe plates 2602. Thus, the distraction instrument 2400 prevents overdistraction that which results in inaccurate measurements and possibleinjury.

FIG. 26 illustrates a perspective view of the components of theretraction head 2404 of the retraction instrument 2400 according to someembodiments. As shown in FIG. 26 , the retraction head 2404 comprises apair of retraction plates 2602 coupled together by a rear jack assembly2604 and a front jack assembly 2606. The rear and front jack assemblies2604, 2605 each comprise a rear/front fitting 2614, 2615 having afitting conduit 2616 and coupled to a plurality of legs 2622 via one ormore fitting pins 2620. Specifically, the plurality of legs 2622 eachhave a leg pin 2624 and a leg aperture 2619, wherein the leg apertures2619 are configured to slide onto a pair of fitting protrusions 2621such that the legs 2622 are able to pivot/rotate about the fittingprotrusions 2621 and are prevented from sliding off the protrusions 2621by the fitting pins 2620. As shown in FIG. 26 , two fitting protrusionsare each rotatably coupled to a pair of legs 2622. Alternatively, moreof less fitting protrusions 2621 are able to be rotatably coupled tomore or less legs 2622. Alternatively, the protrusions 2621 and/orfitting pins 2620 are able to be omitted and the legs 2622 are able tobe rotatably coupled to the fittings 2614, 2615 via other couplingmechanisms as are well known in the art.

In some embodiments, the conduit 2616 of the rear fitting 2614 is barewhereas the conduit 2616 of the front fitting 2615 has an innerthreading 2618 that is operably coupled to the threaded portion 2512 ofthe engaging element 2504 when the engaging element 2504 is positionedwithin the conduits 2616 of the retraction head 2404. As a result, theengaging element 2504 is able to freely move independent of the rearfitting 2614, but causes the front fitting 2615 to move toward or awayfrom the rear fitting 2614 along the engaging element 2504 when rotated.Alternatively, the threading 2618 of the conduit 2616 of the frontfitting 2615 is able to be omitted and the engaging element 2504 is ableto be otherwise coupled to the front fitting 2615 such that when theengaging element 2504 is pulled into or pushed out of the guide element2506 the coupling causes the front fitting 2615 to correspondingly slidetoward or away from the rear fitting 2614. In some embodiments, the rearfitting 2614 comprises one or more stop apertures 2617 that couple withthe stop pins 2510 in order to prevent the distraction head 2402 fromrotating with the engaging element 2504 and to keep the rear fitting2614 of the rear jack assembly 2604 in contact with the end of the guideelement 2506. Alternatively, the stop pins 2510 and stop apertures 2617are able to be omitted and the rear fitting 2614 is able to be coupledto the guide element 2506 via other coupling mechanisms as are wellknown in the art.

The retraction plates 2602 each comprise one or more leg pin apertures2608, a pair of fitting cavities 2610 and a plate channel 2612. The legpin apertures 2608 are configured to rotationally couple to the leg pins2624 such that the plates 2602 are coupled together via the front andrear jack assemblies 2604, 2606. Specifically, when the legs 2622 arecaused to rotate about the protrusions 2621 (due to movement of theengaging element 2504), the legs 2622 also rotate within the leg pinapertures 2608 about the leg pins 2624 causing the plates 2602 toselectively move apart or come together. When the plates 2602 arepositioned together the fitting cavities 2610 and plate channels 2612 ofthe upper plate 2602 align with the fitting cavities 2610 and platechannel 2612 of the lower plate 2602. As a result, the height of theretraction head 2404 in the retracted position is minimized because therear and front fittings 2614, 2615 are able to fit within the alignedfitting cavities 2610 and the engaging element 2612 is able to fitwithin the aligned plate channels 2612. This provides the advantage ofminimizing the size of the required surgical incision for the bonefusion surgery measurement operation.

FIGS. 27A and 27B illustrate cross sectional view of the head 2404 ofthe retraction instrument 2400 with the plates 2602 fully retracted andfully extended, respectively, according to some embodiments. As shown inFIG. 27A, when the retraction instrument 2400 is in the retractedposition, the plates 2602 are in contact such that the fittings 2614,2615 are all or partially housed within/between the plates 2602. Whilein this position, the retraction instrument 2400 creates the smallestprofile possible and thus is able to be surgically inserted between twovertebrae of a patient with a minimally invasive procedure. As shown inFIG. 27B, once in position, the user is able to rotate or otherwise movethe engaging element 2504 within the guide element 2506 and head 2404 bymanipulating the handle 2502. This manipulation causes the front fitting2615 to selectively move closer to the rear fitting 2614 andcorrespondingly the plates 2602 to move away from each other until thedesired measurement has been made or the maximum height has been reacheddue to the front fitting 2615 contacting the rear fitting 2614 along theengaging element 2504. The, user is then able to retract the plates 2602back together for removal using the opposite rotation and/or oppositeother movement of the engaging element 2504 via the handle 2502.Accordingly, the retraction instrument 2400 provides the advantage of aminimized retracted profile that enables a surgeon to measure the sizeof the space needed to be filled by a bone fusion device or other devicewhile minimizing the surgical incision required to take the measurement.

FIG. 28 illustrates a flow chart of a method of operating the retractioninstrument 2400 according to some embodiments. A user rotates orotherwise moves the engaging element 2504 until the head 2404 is in afully retracted position at the step 2802. The user inserts theretraction instrument 2400 into the desired position within the patientat the step 2804. In some embodiments, the desired position comprisesbetween or adjacent to one or more vertebrae. In some embodiments, theretraction instrument 2400 is inserted anteriorly. Alternatively, theretraction instrument 2400 is able to be inserted posteriorly, lateral,far-lateral or transforaminaly. The user rotates or otherwise moves theengaging element 2504 until the head 2404 is extended to a desiredheight at the step 2806. In some embodiments, the desired heightcomprises the height required such that the lower and upper plates 2602abut the vertebrae. The indicators 2508 indicate the amount ofseparation between the plates 2602 at the step 2808. In someembodiments, the indicators 2508 indicate a type and/or size of bonefusion device to utilize to fill the measured space. In someembodiments, the indicators 2508 indicate a number ofrotations/revolutions that the positioning element of a bone fusiondevice will require in order to extend the tabs to the height indicatedby the amount of separation of the plates 2602. In some embodiments, theindicators 2508 indicate the current amount of expansion resisting forceon the plates 2602. In some embodiments, the desired height comprisesthe height or separation of the lower and upper plates 2602 when theindicators 2508 indicate the plates 2602 are experiencing apredetermined expansion resisting force threshold value. The userretracts and removes the retraction device 2400 from the patient at thestep 2810. In some embodiments, the user then inserts the a bone fusiondevice into the desired position and extends the tabs such that the bonefusion device fills the indicated height. In some embodiments, the userextends the tabs such that the bone fusion device fills the indicatedheight by rotating the positioning element of the bone fusion device anumber of times indicated by the indicators 2508. In some embodiments,the bone fusion device inserted was selected based on size and/or typeof bone fusion device indicated by the indicators 2508. Therefore, theretraction instrument 2400 provides the advantage of determining thesize of the space within the patient while only requiring a smallincision and minimally invasive (arthroscopic) surgical procedure whichadvantageously promotes health and rapid recovery by the patient.Further, by determining the size of the space to be filled, theinstrument 2400 provides the advantage of enabling the user to select abone fusion device of the appropriate size to fit within the space andenables the user to pre-configure the tabs of the bone fusion device tonear the height required to fill the space such that minimal extensionof the tabs is required when the device is in place within the patient.

The bone fusion device, system and method described herein has numerousadvantages. Specifically, the RFID chips provide the advantage ofenabling identifying and other data to be retrieved from the chips. Thestops provide the advantage of preventing the tabs and/or nested levelsof the tabs from falling or extending too far out of the body of thedevice. The retention springs provide the advantage of biasing the tabsin the retracted position such that they do not get stuck or otherwisenot properly retract when the extending blocks are moved to theretracted position. The nested tab levels provide the advantage ofproviding increased lateral support to the tab as it is extended as wellas enabling increased stable extension while still minimizing the formfactor of the device in the retracted position. The tongues provide theadvantage of maintaining an increased surface area of the innermost tablevel for increased contact with the bones as well as enabling the innersurface profiles of the tab levels to be simplified as the raising ofthe outer tabs also raises the inner tabs due to the tongues. Moreover,as mentioned above, the small incision and minimally invasive(arthroscopic) surgical procedure advantageously promote health andrapid recovery by the patient. Preferably, bone growth occurs around thebone fusion device and particularly at the locations of the extendedtabs, such that the bone fusion device is further secured by the bonegrowth, which further promotes a superior, robust bone fusion result.

The present invention has been described in terms of specificembodiments incorporating details to facilitate the understanding ofprinciples of construction and operation of the invention. Suchreference herein to specific embodiments and details thereof is notintended to limit the scope of the claims appended hereto. It will beapparent to those skilled in the art that modification may be made inthe embodiments chosen for illustration without departing from thespirit and scope of the invention.

1-43. (canceled)
 44. A bone fusion device for insertion between bonescomprising: a body having first and second ends; an interior cavitydeposed between the first and second ends; a conduit providing a pathwayfrom the interior cavity to outside of the body; one or more tabs forbracing the bone fusion device in a space between the bones, each of theone or more tabs comprises an outer surface, an angled inner surface, afirst side end and a second side end, wherein each of the one or moretabs is shaped such that the first side end is substantially larger thanthe second side end and a size of the tab in between gradually decreaseswhile going from the first side end to the second side end; apositioning element positioned through the first end and substantiallywithin the interior cavity; and an extending block coupled to thepositioning element and comprising one or more angled surfaces abuttingagainst the one or more tabs for moving the one or more tabs when thepositioning element is rotated, wherein the extending block moves towarda head of the positioning element to extend the one or more tabs. 45.The bone fusion device of claim 44, wherein the positioning element iseither a screw or a bolt.
 46. The bone fusion device of claim 44,wherein the extending block is a nut.
 47. The bone fusion device ofclaim 44, wherein the one or more tabs further comprise one or moreholes.
 48. The bone fusion device of claim 44, wherein the one or moretabs are movable to a compact position such that the bone fusion devicehas a minimized form factor.
 49. The bone fusion device of claim 44,wherein the one or more tabs are configured for a plurality ofpositions.
 50. The bone fusion device of claim 44, further comprising abone graft material pre-deposited into the interior cavity beforeinsertion of the bone fusion device between the bones.
 51. The bonefusion device of claim 44, further comprising a bone graft material thatis applied after placement of the bone fusion device between the bones.52. The bone fusion device of claim 44, further comprising a rectangularshape.
 53. The bone fusion device of claim 44, wherein a material of thebone fusion device is biocompatible.
 54. The bone fusion device of claim44, further comprising serrated edges on the one or more tabs.
 55. Thebone fusion device of claim 44, further comprising one or more pins andone or more slots for allowing movement of the one or more tabs.
 56. Abone fusion device for insertion between adjacent bones, comprising: ahollow body having one or more holes along a length of the hollow body;one or more moveable tabs, wherein each of the one or more moveable tabscomprises an angled inner surface, a first portion and a second portion,wherein each of the one or more moveable tabs is shaped such that thefirst portion is larger than the second portion and a size of the tab inbetween decreases while going from the first portion to the secondportion forming the angled inner surface; a positioning elementpositioned through a part of the hollow body and substantially withinthe hollow body; and an extending block coupled to the positioningelement and comprising one or more angled surfaces abutting against theangled inner surface of the one or more tabs for moving the one or moremoveable tabs when the positioning element is moved.
 57. The bone fusiondevice of claim 56, wherein the positioning element is either a screw ora bolt.
 58. The bone fusion device of claim 56, wherein the extendingblock is a nut.
 59. The bone fusion device of claim 56, wherein the oneor more tabs further comprise one or more holes.
 60. The bone fusiondevice of claim 56, wherein the moveable tabs are deposed to at leastpartially lie within the hollow body of the bone fusion device such thatthe bone fusion device has a small form factor.
 61. The bone fusiondevice of claim 56, wherein a material of the bone fusion device isbiocompatible and utilized with vertebral bones.
 62. The bone fusiondevice of claim 56, wherein bone graft material is applied afterinsertion and placement between the bones.
 63. The bone fusion device ofclaim 56, wherein the moveable tabs have a textured surface.
 64. Thebone fusion device of claim 56, wherein the moveable tabs are coatedwith a porous material.
 65. The bone fusion device of claim 56, furthercomprising serrated edges on the one or more tabs.
 66. A method ofimplanting a bone fusion device between bones, the method comprising:inserting the bone fusion device between the bones, wherein the bonefusion device comprises a body having a first end, a second end, aninternal cavity deposed between the first end and the second end, apositioning element, an extending block and one or more moveable tabs,wherein the extending block comprises one or more angled surfacesabutting against the one or more moveable tabs and each of the one ormore moveable tabs comprises an outer surface, an angled inner surface,a first side end and a second side end, wherein each of the one or moremoveable tabs is shaped such that the first side end is substantiallylarger than the second side end and a size of the tab in betweengradually decreases while going from the first side end to the secondside end; pre-configuring the one or more moveable tabs using thepositioning element with the extending block such that the bone fusiondevice has a minimized form factor; and extending the one or more tabsto a desired position by moving the extending block by rotating thepositioning element.
 67. The method of claim 66, wherein rotating thepositioning element clockwise moves the extending block, forcing the oneor more moveable tabs outward.
 68. The method of claim 66, whereinrotating the positioning element counterclockwise moves the extendingblock, allowing the one or more moveable tabs to move inward.
 69. Themethod of claim 66, further comprising before implantation, depositing abone graft material into the cavity.
 70. The method of claim 66, furthercomprising applying bone growth material to the one or more tabs afterextension, wherein the bone growth material stimulates regeneration ofbone cells in the bones.
 71. The method of claim 66, wherein the one ormore moveable tabs further comprise serrated edges.
 72. The method ofclaim 66, wherein extending the one or more moveable tabs utilizes oneor more pins and one or more slots.
 73. A bone fusion device forinsertion between bones comprising: a body having a first end and asecond end; an interior cavity deposed between the first end and thesecond end; one or more tabs for bracing the bone fusion device in aspace between the bones, each of the one or more tabs comprises a firstportion, a second portion and an angled inner surface between the firstportion and the second portion, wherein each of the one or more tabs isshaped such that the first portion is larger than the second portion anda size of the tab in between the first portion and the second portiondecreases while going from the first portion to the second portion; apositioning element positioned through the first end and at leastpartially within the interior cavity; and an extending block coupled tothe positioning element and comprising one or more angled surfacesabutting against the angled inner surface of the one or more tabs. 74.The bone fusion device of claim 73, wherein the positioning element isat least partially threaded.
 75. The bone fusion device of claim 73,wherein the positioning element is positioned through the extendingblock.
 76. The bone fusion device of claim 73, wherein the one or moretabs further comprise one or more holes.
 77. The bone fusion device ofclaim 73, wherein the one or more tabs are movable to a compact positionsuch that the bone fusion device has a minimized form factor.
 78. Thebone fusion device of claim 73, wherein the one or more tabs areconfigured for a plurality of positions.
 79. The bone fusion device ofclaim 73, further comprising a bone graft material pre-deposited intothe interior cavity before insertion of the bone fusion device betweenthe bones.
 80. The bone fusion device of claim 73, further comprising abone graft material that is applied after placement of the bone fusiondevice between the bones.
 81. The bone fusion device of claim 73,wherein the body has a rectangular shape.
 82. The bone fusion device ofclaim 73, wherein a material of the bone fusion device is biocompatible.83. The bone fusion device of claim 73, further comprising serratededges on the one or more tabs.
 84. The bone fusion device of claim 73,further comprising one or more pins coupling the one or more tabs withthe body.